CANDIDATE PERSONAL DATA FORM

PHOTO

1. PERSONAL DATA
Last Name First Name Middle Name

Home Street address City

State Country of Residency Zip/Postal code Airport City

Telephone 1 Telephone 2 E-mail Skype ID

2. OTHER INFORMATION
Date of birth Country of birth City of birth Gender
Y □□ FYN□
M F N

Married Nationality Crew Agency

Y □ NYN
□ N

Passport number Country of issue Expiration date

Schengen Visa expiry C1D expiry Panama Book Seaman National Book
Y □ NYN
□ N Y □ NYN
□ N

STCW95 Institution Issue date

Y □ NYN
□ N

Yellow Fever Issue date

Y □ NYN
□ N

Have you ever been convicted of a crime (other than a minor traffic violation)?
Y □ NYN
□ N
If Yes, please explain:
 CANDIDATE PERSONAL DATA FORM

3. EDUCATION
Highest education Level Program/Main Subject

Start date End date Institution Country/Region

3.1 Professional courses

Title Certifications Institution Country/Region

Status: Finished □ In progress □ Issue date:

Title Certifications Institution Country/Region

Status: Finished □ In progress □ Issue date:

4. PROFESSIONAL PROFILE (from the last one)
Job Title Main duties Start date

End date Salary Employer Sector

Agency Reason for Leaving References (Name‐Telephone‐email)

Job Title Main duties Start date

End date Salary Employer Sector

Agency Reason for Leaving References (Name‐Telephone‐email)

Job Title Main duties start date

end date salary employer Sector

Agency Reason for Leaving References (Name‐Telephone‐email)

 CANDIDATE PERSONAL DATA FORM

5. CRUISE EXPERIENCE
Have you previously applied for a job with MSC? Position Department

Have you previously worked for MSC? Position held/Years Crew ID number

Have you worked for other Cruise Lines? Position held/Years Cruise Line name

6. LANGUAGES
Level English Spanish Italian
Beginner □ □ □
Intermediate □ □ □
Upper Intermediate □ □ □
Advanced □ □ □
Mother Tongue □ □ □
Level French German Portuguese
Beginner □ □ □
Intermediate □ □ □
Upper Intermediate □ □ □
Advanced □ □ □
Mother Tongue □ □ □
Level Other: Other: Other:
Beginner □ □ □
Intermediate □ □ □
Upper Intermediate □ □ □
Advanced □ □ □
Mother Tongue □ □ □
7. COMPUTER SKILLS
Level Internet E-Mail/Outlook Word Processor
Beginner □ □ □
Intermediate □ □ □
Advanced □ □ □
Level Database/Access Spreadsheet/Excel Fidelio
Beginner □ □ □
Intermediate □ □ □
Advanced □ □ □
Level Mac Publisher
Beginner □ □
Intermediate □ □
Advanced □ □
Date________________ Place________________ Signature_______________

In accordance with the International Labour Conference and the Maritime Labour Convention (2006) that establishes rules for members
adopting a system of Seafarers’ Employment Agreements,
Crew members must pay for:
1.Passport;
2.A National Seaman’s Book;
3.A Panama Seaman’s Book;
4.A comprehensive Medical Examination that meets the requirements of the Company;
5.A valid certificate to show you have passed a course in Basic Safety Training, STCW, Crowd & Crisis Management and other
Watchkeeping courses.
Crew members must not pay for:
1.Apart from training costs and valid direct expenses for documents etc (as described above), any additional payment to any Agent or
other person to embark;
2.Any payment, gift or favor to any person on board for any reason (to be re-hired, to be promoted, to move to another department
etc.);
3.Crew members must know that it is illegal to ‘pay for a job’, (or for an Agent or any person on board to accept money from them).

The undersigned declares the acknowledgement of information provided above

Date _ Place ____ Signature _______________________

I hereby authorize the use of my personal data in compliance with the Italian Legislative Decree no. 196/2003